Tibial Spine Fractures: Open Treatment

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Abstract

A tibial spine fracture is a bony avulsion of the attachment of the anterior cruciate ligament. These fractures are most commonly seen in skeletally immature children and adolescents aged 8–14 years, as the bone is the point of failure with the anterior cruciate ligament (ACL) actually being stronger in resisting tensile forces than the incompletely ossified tibial plateau. These are often sports-related injuries with a mechanism similar to that of ACL tears in adults, mainly hyperextension combined with a valgus or rotational force. In up to 40% of cases, there may be associated injury to the meniscus, capsule, or collateral ligaments (LaFrance et al. 2010). Tibial spine fractures are classified by the degree of displacement (Meyers/McKeever classification): type I is nondisplaced, type II is anterior cortical displacement with an intact posterior hinge, and type III is a completely displaced fragment. A type IV was added later which is a comminuted fragment. The goals of treatment are to restore the integrity and function of the ACL along with the normal contour of the tibial plateau.

References and Suggested Reading

  1. Edmonds EW, Fornari ED, Dashe J, Roocroft J, King M, Pennock A (2015) Results of displaced pediatric tibial spine fractures: a comparison between open, arthroscopic, and closed management. J Pediatr Orthop 35(7):651–656CrossRefPubMedGoogle Scholar
  2. Herman MJ, Martinek MA, Abzug JM (2014) Complications of tibial eminence and diaphyseal fractures in children: prevention and treatment. J Am Acad Orthop Surg 22(11):730–741CrossRefPubMedGoogle Scholar
  3. LaFrance RM, Giordano B, Goldblatt J, Voloshi I, Maloney ML (2010) Pediatric tibial eminence fractures: evaluation and management. J Am Acad Orthop Surg 18(7):395–405CrossRefPubMedGoogle Scholar
  4. Watts CD, Larson AN, Milbrandt TA (2016) Open versus arthroscopic reduction for tibial eminence fracture fixation in children. J Pediatr Orthop 36(5):437–439CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of OrthopaedicsNationwide Children’s HospitalColumbusUSA

Section editors and affiliations

  • Eric D. Shirley
    • 1
  1. 1.Pediatric Orthopaedic AssociatesAltantaUSA

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